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Idiopathic nephrotic syndrome and rituximab: may we predict circulating B lymphocytes recovery?

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Abstract

Background

Rituximab (RTX) has been shown to be an efficient treatment for steroid-dependent nephrotic syndrome (SDNS). A long B cell depletion period seems to improve the duration of remission. This study reports the duration of B cell depletion after each RTX infusion in patients with nephrotic syndrome.

Methods

We retrospectively report the data of 22 patients with a diagnosis of a SDNS or steroid-resistant nephrotic syndrome (SRNS) and a treatment with RTX in a single center. B cell depletion duration was compared to the first B cell depletion duration and to the previous B cell depletion duration in each patient.

Results

Twenty-two patients (5 girls) were included. Seventy-six periods of B cell depletions were compared to the first B cell depletion duration and to the preceding B cell depletion duration in the same patient. Total duration of B cell depletion was 26 (6–66) months. Individual post-RTX infusion B cell depletion duration was 5.1 (1.6–14) months. Median B cell depletion duration following the first RTX cure for children who had received 1 to 2 infusions at first cure was not statistically different of those who had received 3 to 4 infusions (p = 0.18). Comparing the B cell depletion induced by previous RTX courses and the following B cell depletion, 89.5% of patients had a similar duration within an open interval from 2 months.

Conclusion

Once the individual time interval until B cell recovery is determined, monitoring could be individualized by targeting the expected date of B cell recovery or by performing pre-emptive RTX injections.

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Authors and Affiliations

  1. Pediatric Nephrology, Department of Pediatric Nephrology, Armand Trousseau Hospital, APHP, 26 Avenue du Docteur Arnold Netter, 75012, Paris, France

    Jean Daniel Delbet, Gael Leclerc & Tim Ulinski

  2. University Pierre and Marie Curie, Paris 6, Paris, France

    Jean Daniel Delbet & Tim Ulinski

  3. DHU 2iB, Inflammation-Immunotherapy, Paris, France

    Tim Ulinski

Authors
  1. Jean Daniel Delbet
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  2. Gael Leclerc
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  3. Tim Ulinski
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Correspondence to Tim Ulinski.

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The study complies with the Helsinki Declaration and was approved by the local institutional ethics committee.

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The authors declare that they have no conflict of interest.

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Delbet, J.D., Leclerc, G. & Ulinski, T. Idiopathic nephrotic syndrome and rituximab: may we predict circulating B lymphocytes recovery?. Pediatr Nephrol 34, 529–532 (2019). https://doi.org/10.1007/s00467-018-4139-4

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  • DOI: https://doi.org/10.1007/s00467-018-4139-4

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